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Chapter 17 The Final Challenge: Death and Dying


Chapter 17 The Final Challenge: Death and Dying Biological Definitions of Death Harvard: Total Brain Death Unresponsive to stimuli No movement or breathing No ... – PowerPoint PPT presentation

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Title: Chapter 17 The Final Challenge: Death and Dying

Chapter 17 The Final Challenge Death and Dying
Biological Definitions of Death
  • Harvard Total Brain Death
  • Unresponsive to stimuli
  • No movement or breathing
  • No reflexes
  • Flat EEG
  • Euthanasia happy or good death
  • Hastening death of someone suffering incurable
    illness or injury

Social Meanings of Death
  • Modern American
  • Medical failure
  • More traditional societies
  • Natural part of life cycle
  • Grieving practices vary
  • By culture weeping/partying
  • By ethnicity wake/Shiva

Life Expectancy
  • Expected age at death
  • U.S. 76.5 years
  • White females 80 years
  • White males 75 years
  • Black females 75 years
  • Black males 68 years
  • Ancient Rome 30 years

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  • Figure 17.1

Theories of Aging and Death
  • Programmed theories
  • Maximum life span (species specific)
  • Hayflick Limit cells from embryos divide a
    limited amount 50 10 for adult cells even less
  • Damage Theories
  • Free radicals toxic by-products of the
    metabolism of O2 damage cells and their
    functioning (also damage DNA)
  • Interaction of the two or more

Kubler-Rosss Stages of Dying
  • Common set of stage-like emotions
  • Denial, anger, bargaining, depression, acceptance
  • Criticisms
  • Not a stage-like process
  • Course of illness not considered
  • Individual differences

Attachment Model of Bereavement
  • Bereavement the state of loss
  • Grieving emotional expressions
  • Anticipatory grief
  • Mourning culturally approved reactions
  • Parks/Bowlby Model
  • Reaction to separation from a loved one
  • Numbness, yearning, despair, reorganization (not

  • Figure 17.2

The Infant
  • Object permanence all gone
  • Attachment by 6-8 months
  • Separation anxiety at loss
  • Protest, yearning, searching despair
  • Behavioral eating, sleeping, regression
  • Less distress if attached to other parent
  • Eventual new attachments and recovery

The Child
  • The mature concept of death
  • Finality, irreversibility, universality,
    biological causality
  • Age 3-5 universality
  • Dead live under altered circumstances (hunger
    pangs, wishes, beliefs)
  • Reversible - life sleep
  • Age 5-7 finality, irreversibility, universality
    (death caused by an external agent)
  • Age 10 biological causality is understood
  • Level of cognitive development, experience
    determine understanding

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The Dying Child
  • Young child aware of impending death
  • Adults often secretive
  • Same range of emotions as dying adults
  • Anxiety revealed in behavior
  • Control is helpful
  • Need support of important others

The Bereaved Child
  • Children do grieve
  • Express grief differently than adults do
  • Misbehavior, strike out, rage
  • Lack adult coping skills
  • Will use denial, avoidance
  • Most adjust successfully

The Adolescent
  • Higher levels of understanding
  • Concerns of adolescence
  • Body image, identity, independence
  • May carry on internal dialogue with dead
  • Devastated at death of close friend
  • Adult-like grieving

The Adult
  • Death of family member difficult
  • Death of spouse more expected with age
  • More difficult when young (non-normative)
  • Elevated levels of stress
  • Risk increases for illness and death
  • Signs of recovery after 2 years

Loss of a Child
  • No loss more difficult
  • Experienced as untimely, unjust
  • Broken attachments
  • Guilt at failure to protect child
  • May continue relationship w/dead child
  • Marital problems often increase afterward

The Loss of a Parent
  • Lasting problems may occur if young
  • Less tragic than unexpected death
  • Adjustment not as difficult
  • Guilt not doing enough for parent
  • Broken attachment

Grief Work Perspective
  • Emotions must be confronted detachment
  • Psychoanalytic, also popular view
  • May be a culturally biased belief
  • Grief work may actually cause more distress
  • Delayed grief reaction predicted w/out it
  • Not supported by research
  • Detachment not necessary

Who Copes and Who Succumbs
  • Secure infant attachment related to coping
  • Low self-esteem related to more difficulty
  • Cause of death influences bereavement
  • Support system essential
  • Additional life stressors detrimental
  • Positive outcomes often found

  • Dying person decides what is needed
  • De-emphasize prolonging life
  • Pain control emphasized
  • Normal setting (if possible)
  • Bereavement counseling for entire family
  • Research shows positive outcomes

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